Many people with inflammatory bowel disease (IBD) know the feeling of panic that can arise when sudden symptoms crop up — particularly those related to bowel urgency and fecal incontinence.
A plan to deal with such situations when they do occur can give you peace of mind, with the knowledge that you won’t be caught unprepared, as well as confidence in your ability to swiftly handle whatever happens.
Bathroom accidents don’t affect everyone with IBD, but they aren’t uncommon with conditions like Crohn’s disease or ulcerative colitis (UC). Estimates of fecal incontinence in IBD vary widely, ranging between 20 percent and 73 percent.
The situation can cause you to feel psychological distress and avoid social contact, according to research.
Unfortunately, such stress may worsen symptoms.
The good news is that, as many people with IBD have found, preparation can be useful in reducing worry, alleviating fear about accidents, and dealing with them if they happen. Here are some tips that can help.
1. Carry an Emergency Kit
One good strategy is to carry everything you might need in an emergency in a small bag, says Adam Pont, MD, a gastroenterologist with the Medical Offices of Manhattan in New York City.
- Disposable incontinence pads or underwear
- Change of clothes, including undergarments
- Bathroom wipes
- Hand sanitizer
- Plastic bags
- Moisturizing cream to ease skin irritation
You might even consider having several of these bags in different locations — for example, one at work and one in your car — in addition to one you carry with you.
2. Talk With Your Doctor
Because the risk of bathroom accidents tends to be higher when your IBD is active, it’s important to check in with your healthcare provider about strategies that could reduce the frequency of flares, says Dr. Pont.
Even if you’re in remission, checking in with your doctor can be helpful, especially if fecal incontinence is a regular occurrence.
“Having active gut inflammation increases your chances of a bathroom accident, so it’s crucial to make sure your IBD is under control,” he says. “If you’re in remission and having accidents, it’s possible you have anal fistulae or a perianal issue, which can weaken muscles that keep stool inside and lead to accidents.”
Keep in mind that fecal incontinence is often part of IBD, so even though it may be difficult or awkward to talk about, these conversations are an essential step toward addressing the challenge.
3. Scope Out Your Bathroom Options
In the same way flight attendants suggest scanning a plane before takeoff so you know where the exits are and how to reach them, a quick check of your environment is useful to see where bathrooms are located, says Pont.
You might choose to sit closer to a bathroom during a party, for example, or ask for a restaurant table in a bathroom-adjacent section instead of sitting farther away. At work, consider asking for disability accommodations that allow you to sit near the bathroom and take bathroom breaks whenever necessary.
There are even smartphone apps for locating public restrooms when you’re in an unfamiliar location, such as Bathroom Scout and Sit or Squat.
“You want to find out where the bathroom is before it becomes an urgent situation,” he says. It’s also another way to reduce your anxiety about potential accidents — and that assurance might lower your stress levels, which may lower your risk of actually experiencing a problem.
4. Avoid Trigger Foods and Caffeine
If you know you’re going to be in a situation where a bathroom isn’t immediately available, it’s best to avoid foods and beverages that are known to stimulate the bowel, says Randhir Jesudoss, MD, a gastroenterologist at the Orlando Health Digestive Health Institute in Florida.
“This can include foods that are triggers for you personally, but it’s also helpful to avoid eating large quantities of greens or other fibrous foods,” he says. “Milk and other dairy products can also be problematic for many people with IBD, and could lead to bathroom accidents.”
Caffeine is known for triggering the bowels to evacuate, he says. According to one study of nearly 14,000 people, higher caffeine consumption — defined by researchers as more than 86 milligrams per day, or about half of one “short,” 8 ounce coffee at Starbucks — can increase gastrointestinal motility so much that it actually lowers your odds of constipation.
5. Empty Your Bowels Before Leaving Home
Although it’s not always possible to empty your bowels on command, setting some time aside — ideally at the same time each day — to try can be helpful, says Rudolph Bedford, MD, a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California.
“Finding a way to have a complete bowel movement in the morning is usually ideal for preventing bathroom accidents later in the day,” he says. “There are a variety of ways to achieve this; for instance, you may take a large dose of fiber in the form of food or a supplement at night to see if that keeps you on track. Also, morning at home would be the time to make the most of caffeine’s effects to stimulate the bowels.”
When you have IBD, the American Gastroenterological Association recommends that you get most of your fiber from your diet.
Use caution with supplements or foods that have fiber added, unless they’ve been recommended by your doctor. Preliminary research has found that a type of fiber called inulin, commonly used in both, may worsen IBD and the inflammation related to it. While more research on humans is needed, it may be worth discussing with your gastroenterologist first.
While fecal incontinence and bowel urgency are a part of life for many people with IBD, it’s possible to better prepare yourself to deal with them. When you’re confident in your ability to prevent or handle bathroom accidents, it can take away some of the stress and negative feelings related to the issue.
The Takeaway
- Estimates on the prevalence of fecal incontinence in people with IBD vary widely, but the issue affects many people with the condition.
- Preparation is key for preventing bathroom accidents and dealing with them when they happen; being ready also helps to reduce stress and anxiety over potential accidents.
- Strategies like an emergency kit, control of IBD with proper treatment, avoidance of certain foods that stimulate the bowels, and emptying the bowels before leaving home can all prevent bathroom accidents.